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PERMRIEE NAME/ADDRESS pno6i fai4nNr~Lx,Uan 1JD~bmq <br />NAME <br />ter, !.5 •... Y4LL''Y ~:Lt 1, .' 1. :•p. ~Y <br />ADDRESS •.UH'.;[,!? CA!'TOh "Iti•: <br />R.U. FIOY 70 <br />LOr+A CO 915 Z4-0070 <br />F7tER~~I u,YR!tC VII.Lr'Y COAL COI7PiYT <br />' FR( <br />A T'LI~1 J')tlti '!. ~: 4f.T ~. SiS_ MBN18l t•. <br />Form Approvpped-~.!Q77-~D- <br />iE:! PC``i0 r,~Srf}r .•p VAp~d~~plreB-~$~1 kJ8 <br />{S11RR WC) 12345 <br />P - F1gRL <br />'tINORC pr ~~ g <br />T NOTE4 Read lne~lrCucl(iFrr~•iat ny thia Corm. <br />' PARAMETER dOn7y/ QUANTITY OR LOADING rd Onryl OUANTRY OR CONCENTRATION ND. FREQUENCY SAMPLE <br />131.371 d~ 31 154-611 <br />~ 13B-151 /1653 16.-61 <br />EX of <br />TYPE <br /> AVERAGE MAXIMUM UN MINIMUM AVERAGE MAXIMUM UNITS l63~6J1 MALYSIS <br />!6¢66/ 169-7V1 <br />DIL AND ,HP.ASo SAMPLE ^:R4aa ~ -111) ~#~O1i14 a;Faa#; :~;~-:^# <br />V Z _i U A L MEASUREMENT <br /> PERMIT ~.; <br />~~~ ,n> ~: :;:~.: ;:~:. .:.. <br />: ..... ~ <br />.. ~ ... .. <br />' <br />~ . . <br />~. ~ <br />74066 1 0 0 ~ : #w R'x <br />;'` <br />~ , <br />~ <br />~I <br />~~'' <br />' <br />~~ SS=1 . <br />S#i[ <br />,' „ <br />.~ <br />..: <br />lfjxn'+>:b>71~:~. <br />• ,Ifi.;tS(~t:i~ - ~:r!'LY Lit{A; <br /> REQUIREMENT .. <br />. <br />.. <br />;::,~:.. <br />: ~,: f .i:~:' <br />.. .. <br /> , <br />:: _ ,. <br /> SAMPLE <br /> MEASUREMENT "' D V <br /> :.. PERMIT <br />~ ~ <br />~ ::. sx::,.; ...~..., <br />~ .. <br /> ~:REOUIREMENT . <br />. : <br />~ :1 ..~~ ~: :: <br /> .. :::;~. <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> .REQUIREMENT ~~. ~-'~~:~.::~;:~:~~..~ <br />:.. ~~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ ::... :. .. <br />,..:.::: b:~:cs ...... <br />.. ~ <br />~ :~: <br /> REQUIREMENT .. ~ ~ ~ ~ ' <br /> SAMPLE <br /> MEASUREMENT <br /> ~~PERMIT <br /> :REQUIREMENT :.: ~: ,:: ~.~~. ~ . . <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ .~:~: :.~~.:~:...: ... .... ,.. .: .:.:. .. <br /> ~REQVIREMENT ~~:~~~ ~~~~^~ ~~ ~~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />~ <br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I cERTI <br />AM FA FV ueoeR PENUTr oF <br />MILIM WITH THE INFO uw man NAVE PERSONALLY EXAMIN <br />RMATION SUBMITTED HEREIN; MD BA ED Mo <br />SED ON ; TELEPHONE DATE <br /> MY INQUIRY OF THOSE INgNDUALS IMMEDIATELY RESPONSIB LE FO <br /> <br />JOHN M WALTt7tS OBtAINING THE INFORMATION, I BEVEVE tHE SUBMITTED INFORMA <br />TRUE, ACCURATE MD COMPLETE. 1 AM AWME THAT THE <br />SIGHIFICM7 PENALTIES F <br />BMITTING FALSE INFORMATION <br />IN TION I <br />RE M <br />CLUDING <br />~~ <br />MANAGER OF MINE SERVICES , <br />OR SU 970 ~ <br />/B - 3~ ~ ~ 3 <br /> THE POSSIBILITY OF NNE MD IMPRISONMENT. SEE 18 U.S.C. 1 1001 MD 03 gIONATURE OF PRINCMAL EXECUTIVE . <br /> U.S.C. f 1310. IMWa„ uqr lwAr ,urur„ m,Y ~•rA.d. /wa yo ro F 10,000 AREA <br />TYPED OR PRINTED rla a•muim.n Mpi,annrlt olNwwn enHnNa rd6ywa/ OFFICER OR AUTHORREO AGENT CODE NUMBER YEAR MO DAV <br />GOMMEN I5 AND EXYLANA I I V N V Y ANY V I V LA 11 V NS 1Me76/once N/ efbCnmen f9 N/el <br />Y <br />l::+? E'0'.Pd1. !FO•: LIF;I°. iTLL =.: NA[YFD, .4ND `i~:T':LBAhL'. .?OL?D ~ L"T APCT.IED FO 1' <=1/IYR,249k PR4CIP EY`+I?~ <br />'~~•TILEA9LE SOLTUS LIrIT MA'f BF YAIVftU FOS >10!H,2~NF CVEVT-S F. P. I.~.1, PP 3-4, AND T.A,7, p. 7, rRTkLT <br />a e J1 rtio tm be ue T A• W O ~ O • ~- <br />00252/9F1217-1206 <br />